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Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and the second leading cause of cancer death in the world. It is the only tumor that can be diagnosed by imaging only, without a need for histopathological confirmation. CT and MR are the imaging techniques that often allow making a definite diagnosis. This study is a prospective study done by multiphasic contrast-enhanced computed tomography on 25 patients with liver cirrhosis showing 30 hepatic arterial phase hyper-enhancing nodule. Follow-up CT studies for these nodules were performed 4 to 6 months after the initial study In the follow-up study, 14 (46.66%) lesions showed size progression; however, only 4 of them had a progression which was more than 50% (threshold progression as described in LI-RADS version18). Nine (30%) lesions showed stationary size, and 7 lesions (23.33%) disappeared. Regarding the enhancement dynamics, 2 lesions developed delayed non-rim washout. By application of the LI-RADS classification, LI-RADS 3 category was noted in 25 lesions, and only 2 lesions evolved in the follow-up to LI-RADS 5 (using version 17 of the LI-RADS), while using LI-RADS version 18, only 3 lesions evolved. Five lesions were classified as LI-RADS 4 category by LI-RADS version 20017, and all these lesions progressed in size with 2 of them (40%) exceeded the growth threshold in the follow-up and progressed to LI-RADS 5. Using version 18 of the LI-RADS system, these lesions are classified as LI-RADS 5 category in the initial study. The findings of the current study support the modification of the LI-RADS scoring system in the LI-RADS version 2018 upgrading arterial hyper-enhancing lesions with non-peripheral washout ranging from 1 to less than 2 cm from LI-RADS 4 to LI-RADS 5.

the egyptian journal of radiology and nuclear medicine /the egyptian journal of radiology and nuclear medicine

Assessment of the follow-up interval changes of the less than 2 cm arterial phase enhancing hepatic nodules in correlation with Liver Imaging Reporting and Data System (LI-RADS) classification version 18 using contrast-enhanced multidetector computed tomography